Transforming lives: Evidence of Mezirow's perspective transformation in substance abusers undergoing family-of-origin therapy

Gerald Mathis Rich


Substance abuse remains a high priority in the United States despite state-of-the-art inpatient treatment programs, the proliferation of outpatient programs, and innumerable self-help recovery groups. Moreover, the societal costs of substance abuse continue to increase as evidenced by the growing burden to the legal system, the rise in prison populations, and increasing cost of health care. The researcher sought a better understanding of family-of-origin therapy as a treatment modality for substance abuse. More particularly, this therapy was believed to be a form of self-directed learning capable of yielding changes in the substance abuser's personal identity and relationships that were necessary to a sustained recovery. Those changes were believed to be characteristic of a change in personal outlook consistent with Mezirow's theory of perspective transformation. The Personal Orientation Inventory (POI) was used to assess the degree of change in a treatment group receiving therapy. All subjects were tested at the beginning of the study and at the conclusion of therapy, approximately 6 months later. In this manner, the researcher sought descriptive evidence in support of family-of-origin therapy and perspective transformation. Three subjects participated in a treatment regimen of approximately six months. All three presented with varying degrees of what Mezirow called disorienting dilemmas (i.e. potential and/or actual conflict with existing belief systems, attitudes, behavior, etc.). The youngest two subjects had experienced little hardship that was attributable to their substance abuse. These two participants evidenced little change. The most change was evidenced by the eldest subject whose quality of life had been substantially impacted by substance abuse. This individual utilized family-of-origin therapy to redefine his personal identity as well as his relationships with family members; he was the only subject who abstained from drugs and alcohol during the study. The study concluded that perspective transformation has a positive relationship with the degree of the disorienting dilemma: in other words, the greater the dilemma, the greater the transformation.